I have a dillemma about ice. I am well aware that ice chould only be used for fresh, acute injuries and not handed out for every little ache or pain, however, it has become a battle of the4 wills in my school that I have lost. I am in a high school, and the students use the clinic for ev ery excuse to get out of class. New Admin is not supportive of my prior practices to keep students out fo the clinic and in class. When they come for ice, I pretty much have to just hand it out like candy, no matter what the issue, or how old the issue is. If I explain that ice is no longer indicated for the "injury" the kids can text, or call their parents, some of which will call, screaming and yelling about just give them the ice, and if we persist, they call admin, and we get yelled at by admin. So, in a nutshell, we are now just handing ice out to anyone that simply asks for it no matter what. It keeps the parents, and the administrators from yelling and screaming about ice. Suggestions????
For my high-schoolers with invisible injuries, I've learned to keep them in here to ice it. This has cut down on a ton of my ice visits and I've not had to chase down my last few ice packs. I don't want to order more, they're expensive!
I am so so glad you posted this... I almost wrote the exact same question. I keep getting inundated with kids right after recess, who of course couldn't be bothered to miss any time outside to come see me, but now that class has started, you need an ice pack for your buttcheek that you fell on 15minutes ago? I introduced written nurse passes at our faculty meeting yesterday and there was a bit of push-back (mainly in the, "What if we're in the middle of a lesson?" vein) but I was able to bring everyone around when I explained that this will be really great for monitoring purposes... and also found out that some of the classes have floor time and if the kids don't want to be on the floor, their only recourse is to get "medical permission" to use a chair for that time, and so they show up to me with a bogus injury requesting an ice pack!!! Now that we have the full story, I am practically ready to throw the ice packs away
You won't win this one. Believe me I have tried! You just end up looking like you don't want to do your job to everyone else because how hard is it to hand out an ice pack? (What they all say.) They have no idea we have to assess and chart on every single student walking through our door. Even the teachers you can get on board will cave the first time a parent calls and complains they didn't let their child come and see you when they were in pain.
Do keep track of how many visits each child is coming for though. If it's a lot you can let the teachers know (some will be more careful of letting them come to you) and let the parents know their child has come to see you X amount of times and you're concerned about how much class they are missing and maybe they need a physical to see if something is causing them to be so sick or hurt all the time. That's worked for me in the past. Good luck!
Ugg the ice packs. I try to be selective about the ice packs but sometimes that is too big of a fight when I am busy. I did have a short time of not handing out any - my fridge ice maker was broken and the cafe was in the middle of replacing their machine so no ice from them - so for about 6 weeks I didn't have any - it was great. Amazing how the kiddos coped without any ice for their invisible injuries, injuries that happened days ago etc.
Specializes in ICU, ER, Home Health, Corrections, School Nurse.
I am well aware of the parameters of when to use ice and when heat, and the reasons why. However, having had physical therapy for orthopedic surgery, I can tell you they use ice after every session. Conversely, when I was being treated for tendonitis of my wrist area they would dip my entire hand into hot wax. so go figure. Regardless of the reasoning, I find that either hot paks or cold paks have incredible curative powers (cough placebo effect cough).
We have a rule that the PE teacher or recess staff person has to call the office for any witnessed student injury at PE or recess that may need an ice pack. This has cut down on those kids just wandering by the office and wanting some attention. They try to stop in for an ice pack and get the "I didn't get a call from your teacher. Go back to class and discuss the injury with them first." I like having another staff member acknowledging an actual injury and not just the kid making it up. Still get a few that probably don't need it, but it has cut waay down on the number of ice packs handed out (and gone missing).
LOL, I was thinking of this post as I was giving out my ice for the "after recess rush". I only give the real big ice packs for an injury that I think really needs it. For everyone else they get ONE ice cube (and it is small cube at that!) in a snack size zip lock!
You can tell that ice is one of my biggest pet peeves by looking at my user name!!! After 13 years experience, I have decided the ice battle is not one thatI am going to fight. I pretty much give it if they ask for it, new or old injury. I do NOT give it any sooner than 2 hours if a kid comes back. I also have 2 separate ice packs I make - 1 for legit, new stuff and wimpy ones for non-existent / old injuries (3-4 small cubes only) so that there still is some nursing assessment involved in which ice pack you get.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
^ Yes, Jen! ^
Big Chill, you're not alone. I have started saying that "you don't need ice for every little thing." And I've called the elementary teachers who sent the kid to say that, in my nursing judgment, ice is not warranted.
Most of them say: "I know but s/he was complaining so I sent him/her."
I have tiny bags that the outgoing nurse left me - she ordered the wrong size. Not good for anything -except an unnecessary ice pack.
You know where the admin wants you to be. I would say let your charting reflect "ice pack for comfort at student request" and let that be. Two more sleeps!!!
Did she really order the "wrong" size? There may have been method to her madness. You may find yourself re-ordering the same size when they run out.
LOL, I was thinking of this post as I was giving out my ice for the "after recess rush". I only give the real big ice packs for an injury that I think really needs it. For everyone else they get ONE ice cube (and it is small cube at that!) in a snack size zip lock!
Don't try this at my school...
That is definitely not a "proper ice pack" and will cause yelly parent phone calls
CanIcallmymom, BSN, RN
397 Posts
For my high-schoolers with invisible injuries, I've learned to keep them in here to ice it. This has cut down on a ton of my ice visits and I've not had to chase down my last few ice packs. I don't want to order more, they're expensive!